The interventional primary care physician


She came to me with complaints of weight gain. I gave her a pill, and she shed 200 lbs. in 2 weeks. No, of course not. There is no such pill.

Mrs. Lopez did not lose weight. At her follow up four months later, she had gained 11 pounds. I went back to my note, and it clearly said that I “counseled her about healthy diet.”

I remember. That was after we discussed optimal management of her diabetes, addressed some of her depression, talked about an asthma action plan, and I probably asked her to watch her diet when she was ready to leave.

Or maybe I don’t remember. Maybe I just thought of writing that under the diagnosis of “obesity, body mass index of 30-35,” some 40-60 patients later during my “admin time.” Because that’s probably what I told her, or would have told any patient suffering with obesity.

Whether I spoke those words or not, it really doesn’t matter. It matters to the quality metrics perhaps, but not to Mrs. Lopez.

I do not deploy coronary stents to restore flow to an ischemic myocardium, but as a primary care provider, I am still programmed to document my interventions. What did I do for Mrs. Lopez? I told her what she needed to do, and I documented that.

At her 4-month follow up, Mrs. Lopez showed she was “noncompliant” with my weight loss plan.

My intervention did not empower her. Should it?

“DrizzleMD” is an internal medicine physician who blogs at his self-titled site, Drizzle MD.

Image credit: DrizzleMD


View 13 Comments >

Most Popular

✓ Join 150,000+ subscribers
✓ Get KevinMD's most popular stories